'It can't be good for the patients' wellbeing'

A MILLION-DOLLAR doctor, thousands of unpaid bills and debts that exceed assets: that's the financial shape of NSW hospitals says the Auditor-General.

Six employees earned more than half a million dollars over the past three years, and one was paid more than $1 million in overtime and call-backs over three years.

The Auditor-General, Peter Achterstraat, said he found it astounding that one person could earn so much overtime.

"Excessive overtime, whether it be rostered, unrostered, or on-call cannot be good for the employees' health and patient well-being" ... Auditor-General Peter Achterstraat. Photo: Bob Pearce

''Excessive overtime, whether it be rostered, unrostered or on-call cannot be good for the employees' health and patient well-being,'' he said.

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The opposition health spokesman, Andrew McDonald, who is a doctor, said it was dangerous. The report found local health districts are struggling to meet goals on the cost of care, with the majority not meeting the first activity based funding targets.

In future, federal funding will be tied to targets.

It found all but one health district had debts that exceeded assets, nearly half were over-budget and long-standing unpaid bills were increasing. The NSW Ministry of Health bailed out some districts with $73 million in extra funding.

Dr McDonald said the Health Minister, Jillian Skinner, had ''outsourced risk'' to hospital districts without providing resources to meet demand.

Ms Skinner said it was normal for the ministry to provide extra funding, particularly in peparation for activity-based funding.

''We've got two years to roll this all out so we've got a bit of time for the districts to get a better understanding of what they have got to do better,'' she said.

She said that the overall health budget would still balance.

She denied that the doctor who earned a million dollars in overtime was necessarily putting patients at risk.

She said overtime payments were ''complicated'' and could involve payments for short periods of time.

''Nevertheless, a lot of the districts are now working hard to reduce overtime,'' she said.

23 comments

This says less about the doctors and staff and more about the government and bureaucrats that are supposed to be running this for our state. It seems the entire public service/health service at the management level is asleep at the wheel and we are all paying for it, literally, and getting a poorer health service as well.

Commenter

Mike

Location

SYD

Date and time

December 19, 2012, 11:50AM

The headline is very misleading. There is a very big difference between earning a million dollars in overtime over one year compared to three years. There is also no mention of how much or even whether the overtime rate was more than the regular rate which is quite relevant to the discussion.

Commenter

Hurrow

Date and time

December 19, 2012, 11:53AM

My son is doing prod grad medicine - he will have done 7 years of study before he starts to earn a cent. With his income he will have off pay off a massive HECS debt. He is independent and works part-time to live. He deserves a decent salary.

mind you he does not deserve to have to work long hours which are a danger to a patient. Many years ago I can remember having a beer and listening to his uncle who lost his first patient, a child, at the end of a very long shift in emergency when he should have been supervised but was not. He was wracked with guilt about whether he could have done better. I argued then and now he should never have been put in that position in the first place

Commenter

a doctors life

Location

sydney

Date and time

December 19, 2012, 12:05PM

Deserves is an interesting choice of words. Way back a mentor once told me, DO NOT do medicine if you are interested in making money because at the end of the day it is still a dollars per hour scenario, or a dollars per operation/patient type deal and essentially capped. Look at Eccelstone... has made more money out of his medical supply business I would wager, than if he had worked for an hourly rate as a Dr and lived ten lifetimes.Every person chooses to take the path they do in Australia and there are many many rewards to being a Dr but certainly money is not one. ("comfortable" finances yes, in exchange for working your butt completely off!)I would challenge any idea of automatic entitlement that comes with any profession. I would also challenge the fact that we have not had a minister of health in my lifetime (and probably longer) that has effectively challenged the cartels (accurate word) that are the various colleges of medicine, not to mention by extension the AMA. Ask any junior Doctor or Doctor in training that has had long enough in the system and if they are courageous enough to be honest with you, they themselves heavily question the entire medical machine in this country from the top down and the bottom up.If you think its expensive getting a medical degree wait until the bills for passing or failing a fellowship come at you, or your risks related to insurance premiums which can put you out of business very easily, such is the current construct.

Commenter

eyeswideopen

Location

earth

Date and time

December 19, 2012, 1:01PM

Very good point you have raised with respect to your son's uncle.

I also agree with the point you have made about your son's salary. I think it's harsh to be overly critical of people for 'trying' when society encourages them to, and then rewards them for doing so...Shouldn't you blame the people who pay them that much? I have only recently began practising as a solicitor after 5 very long years of education during which I probably earned around 10-15k (mainly in scholarships) and refrained from employment in order to attain first class honours. And although I do not believe my salary represents the opportunity cost nor the mental labour, I am happy for those who do get the benefits of their investment as soon as they leave university. In those five years I could have earned at least $200,000 before tax and avoided my $50,000 HECS debt. But didn't, so I could service the world with the provision of highly technical advice. Why wouldn't we be grateful that somebody has dedicated their life to something rather than trash them because others over-value their contribution?

Commenter

Hater

Location

Sydney

Date and time

December 19, 2012, 2:18PM

Yes, 'deserved'?? Perhaps as a real doctor with a PhD after more years of total study than your son, I 'deserve' to rake in millions in overtime in my field. I don't begrudge your son paying off his HECS debt, nor live in comfort as doctors should easily do, but he did choose to be a doctor and the disadvantages that come with that.

Your argument is dangerously close to justifying the 'pigs at the trough' issue of senior doctors in public health (not overworked juniors and their overwork might be less if the system was reformed). I do know a chief anaesthetist well at a largish public hospital who is in the public system only for ethical reasons (and he is paid more than enough, not being greedy). He is damning of the rorts and grubbiness of SOME specialists who have contempt for public health, but use it for the money to the max when not in private clinics.

But then, those annual ski trips to the Alps aren't cheap, and they 'deserve' them because they studied at uni for a couple more years than the plebs.

Commenter

Uncle Ho HO

Date and time

December 19, 2012, 2:51PM

No doctor on this earth is worth $1M in over time charges. What a rip off. I can see a valid trauma doctor earning $450-500K a year - but more than this is out of control. The whole 7 years of study is a cop out at best. A electrician does 4 years training earning $7-14max and has to fork out for fuel, tools, etc. His year 5 income might be $70K. Out of control people.

Commenter

Liberator

Location

SEQLD

Date and time

December 19, 2012, 3:35PM

Teachers and specialist nurses study for about 5 years full time. Psychologists do a minimum of 6 years full time. In the public system, they earn peanuts. They can only dream of the money paid to doctors.

Commenter

Red Pony

Date and time

December 19, 2012, 4:00PM

Ha ha, the "real doctor" debate! I'd rather bestow the title and respect on someone who's in the business of preserving health and saving lives, than somebody who's written a thesis on Renaissance French Literature.

Red Pony: Good point. Next time you have cancer or need bypass surgery, save some money by consulting a teacher or a psychologist.

Commenter

Blimp

Location

Brisbane

Date and time

December 19, 2012, 4:30PM

I more interested in why the Ministry of Health was sitting on $73M, why wasn’t that allocated out to the Hospitals earlier to assist them in managing waiting times etc.